Rethinking mental health and precarity : an innovative city-hospital partnership

Abstract

A public health hospital specializing in mental health, has been increasingly confronted with the social challenges faced by its patients. This has prompted the development of targeted initiatives within the institution. Situated across multiple sites, the hospital serves a densely populated area characterized by socio-economic vulnerability significantly higher than the national average. The goal of our project was to ensure access to medication for outpatients suffering from psychiatric disorders, despite limited resources and the wide geographic area served. An innovative partnership has been developed between the health establishment and local pharmacies for patients experiencing mental health issues and social precarity. In practice, medication dispensing is carried out by nearby pharmacies without any advance payment required from the patient nor any delay. Indeed, our main concern was to provide a secure and fraud-proof method. Sixty partner pharmacies supported over 1,000 patients. This collaboration significantly improves care for vulnerable patients, focusing on autonomy, destigmatization, medication management, and social support. Beyond securing medication management, this partnership advances clinical pharmacy by placing the patient at the heart of the healthcare system and supporting a shift in professional practices. It strengthens the pharmacist’s role in protecting public health and fostering a solid connection with the community. By using resources closest to the patients, we’ve been able to: reduce the waiting time to zero days, decrease medication costs, save time for pharmacy and nursing teams, minimize medication deliveries across the region. This collaborative and adaptable model has been proposed as a national reference and was awarded the 2024 International Prize for Good Use of Medicines by the French Academy of Pharmacy. This project is a compelling example of hospital-born innovation— developed within our public healthcare institution in response to the real-world challenges faced by vulnerable patients. It reinforces the essential role of both hospital and community pharmacists in safeguarding public health, and substantiates their central and legitimate position in driving improvements in patient care. The interest generated by this work reflects its significance, as it not only addresses the medical care aspect but also provides a solution to a health need.

The authors' abstract, as published at the source. Archives of Public Health, 2026 · DOI ↗